Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events. The Formosa Fun Coast Dust Explosion (FFCDE) was studied. Data collection consisted of in-depth interviews with clinicians from four initial receiving hospitals and their relevant hospital records. A detailed timeline of patient flow and emergency department (ED) workload changes of individual hospitals were examined to build the EDs' overload patterns. Data analysis of the multiple hospitals' responses involved chronological process-tracing analysis, synthesis, and comparison analysis in developing an integrated adaptations framework. A four-level ED overload pattern was constructed. It provided a synthesis of specifics on patient load changes and the process by which hospitals' surge capacity was overwhelmed over time. Correspondingly, an integrated 19 adaptations framework presenting holistic interrelations between adaptations was developed. Hospitals can utilize the overload patterns and overload metrics to design new scenarios with diverse demands for surge capacity. The framework can serve as an auxiliary tool for directive planning and cross-check to address the insufficiencies of preparedness plans. The study examined a wide-range spectrum of emergency care responses to the FFCDE. It indicated that solely depending on policies or guidelines for preparedness plans did not contribute real readiness to MCIs. Hospitals can use the study's findings and proposal to rethink preparedness planning for the future beyond surge capacity events.

中文翻译：

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重新思考灾害应急护理中的备灾计划：超能力事件的教训

大规模烧伤灾难会产生威胁医疗保健系统的人员伤亡。本研究提出了一种新方法，用于为这些具有挑战性的超负荷事件制定医院准备和准备计划。研究了福尔摩沙欢乐海岸粉尘爆炸 (FFCDE)。数据收集包括对来自四家初始接收医院的临床医生及其相关医院记录的深入访谈。检查了各个医院的患者流量和急诊科 (ED) 工作量变化的详细时间表，以建立 ED 的过载模式。多家医院响应的数据分析涉及按时间顺序跟踪分析、综合和比较分析，以开发综合适应框架。构建了一个四级 ED 过载模式。它提供了关于患者负荷变化的详细信息以及医院的激增能力随着时间的推移而不堪重负的过程的综合。相应地，开发了一个综合的 19 个适应框架，呈现适应之间的整体相互关系。医院可以利用过载模式和过载指标来设计具有不同需求的新场景。该框架可以作为指导性规划和交叉检查的辅助工具，以解决防备计划的不足。该研究检查了对 FFCDE 的各种紧急护理响应。它表明，仅仅依靠防备计划的政策或指导方针并不能真正为 MCI 做好准备。医院可以使用这项研究'